After receiving his medical degree from Johns Hopkins University School of Medicine, Baltimore, Dr. Siddoway completed an internal medicine residency and clinical pharmacology and cardiology fellowships at Vanderbilt University Medical Center, Nashville. 2015 Oct;148(4):859-864. doi: 10.1378/chest.15-0358. Cannom DS, Caron JF, Part 6: advanced cardiovascular life support: section 1: introduction to ACLS 2000: overview of recommended changes in ACLS from the guidelines 2000 conference. Hypotension frequently occurs with use of intravenous amiodarone and is managed by slowing the rate of administration. Dramatic inhibition of amiodarone metabolism induced by grapefruit juice. Amiodarone Hydrochloride Injection also can be used to treat patients with VT/VF for whom oral amiodarone is indicated, but who are unable to take oral medication. Unable to load your collection due to an error Epub 2009 Feb 14.Cushing DJ, Cooper WD, Gralinski MR, Lipicky RJ, Kudenchuk PJ, Kowey PR.Cardiovasc Toxicol. Epstein AE, Bosker HA, One meta-analysis of 13 studies of patients with congestive heart failure or recent myocardial infarction showed a small reduction in total annual mortality, from 12.3 percent to 10.9 percent (absolute risk reduction [ARR], 2.4 percent; number needed to treat [NNT], 42).Amiodarone is used in the treatment of atrial fibrillation, although the FDA has not approved this indication. Moss AJ, Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Green LD, Sanoski CA, Finally, amiodarone may cause hypotension in approximately 15% of patients receiving it intravenously. Bebee R, Thyroid hormone and the cardiovascular system. In a meta-analysis of 18 RCTs, amiodarone was similar to other antiarrhythmic drugs in its ability to convert patients to normal sinus rhythm (72.1 percent for amiodarone compared with 71.9 percent for other antiarrhythmic drugs).Amiodarone has been associated with toxicity involving the lungs, thyroid gland, liver, eyes, skin, and nerves Chest radiograph; pulmonary function tests, including DInitiate antithyroid drug therapy; consider stopping amiodarone.Consider stopping amiodarone; causal relationship is uncertain.Chest radiograph; pulmonary function tests, including DInitiate antithyroid drug therapy; consider stopping amiodarone.Consider stopping amiodarone; causal relationship is uncertain.The most serious potential adverse effect of amiodarone therapy is pulmonary toxicity, which may result from direct drug-induced phospholipidosis or immune-mediated hypersensitivity.In early studies, the frequency of pulmonary toxicity in amiodarone therapy was 2 to 17 percent.Routine screening for adult respiratory distress syndrome is of limited value, because pulmonary toxicity can develop rapidly with no antecedent abnormalities on chest radiographs or pulmonary function tests. Although the U.S. Food and Drug Administration (FDA) has labeled amiodarone only for the treatment of life-threatening ventricular arrhythmias, the drug also is used to treat atrial fibrillation. Russell RO Jr, Fisher JD, Motte KB, Multicenter Unsustained Tachycardia Trial Investigators [Published erratum appears in N Engl J Med 2000;342:1300]. Eisenberg MJ, Because phlebitis may occur, the drug should be given through a central venous line when possible.Amiodarone is a potent inhibitor of the hepatic and renal metabolism of several drugs Increased incidence of myopathy when simvastatin dosage is higher than 20 mg per dayAdditive effects: possible elevated plasma concentrations of quinidine, disopyramide (Norpace), flecainide (Tambocor), propafenone (Rythmol), and dofetilide (Tikosyn)Additive QT effect: possible increased risk of proarrhythmiaIncreased plasma concentration of hepatically metabolized drugs: possible increased risk of proarrhythmiaIncreased incidence of myopathy when simvastatin dosage is higher than 20 mg per dayAdditive effects: possible elevated plasma concentrations of quinidine, disopyramide (Norpace), flecainide (Tambocor), propafenone (Rythmol), and dofetilide (Tikosyn)Additive QT effect: possible increased risk of proarrhythmiaIncreased plasma concentration of hepatically metabolized drugs: possible increased risk of proarrhythmiaAmiodarone reduces warfarin clearance and can lead to sudden and pronounced increases in the prothrombin time and International Normalized Ratio.Digoxin levels predictably double after coadministration with amiodarone.Patients taking amiodarone should not eat grapefruit or drink grapefruit juice because it can inhibit the conversion of amiodarone to an active metabolite.In patients receiving oral amiodarone therapy, there may be a delay of two weeks or more before antiarrhythmic effects are noted. This response has been attributed to the cosolvents in the formulation and is believed to be solely related to the initial loading dose. Brique SA, Clinical organ toxicity of antiarrhythmic compounds: ocular and pulmonary manifestations. Anaesthetized beagle dogs (n = 7/group) were instrumented to assess haemodynamics. Daubert JP, COVID-19 is an emerging, rapidly evolving situation. Evidence-based analysis of amiodarone efficacy and safety. Liu PP, In contrast, administration of the standard intravenous amiodarone regimen produced rapid and significant decreases in mean aortic pressure, cardiac output and maximum rate of change of left ventricular pressure that persisted throughout the 6 h maintenance infusion period.